This Week in Cardiology

COVID-19 and global vaccinations, AF screening, conduction-system pacing, FDA ban on menthol tobacco, and a heartfelt essay are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-19 Indians Rush for COVID-19 Vaccines as Death Toll Passes 200,000 https://www.medscape.com/viewarticle/950095 - Vaccine Breakthrough Infections with SARS-CoV-2 Variants https://www.nejm.org/doi/full/10.1056/NEJMoa2105000 AF Screening: Modest Clinical Gain for AF Screening of Asymptomatic Elderly: STROKESTOP https://www.medscape.com/viewarticle/949950 - Mass Screening for Untreated Atrial Fibrillation The STROKESTOP Study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.114.014343 - Does screening for disease save lives in asymptomatic adults? Systematic review of meta-analyses and randomized trials https://pubmed.ncbi.nlm.nih.gov/25596211/ - Toward evidence-based medical statistics. 2: The Bayes factor https://pubmed.ncbi.nlm.nih.gov/10383350 Conduction System Pacing Keeping Pace: His-Bundle CRT for Heart Failure Impresses in Second Randomized Trial https://www.medscape.com/viewarticle/950037 - A Randomized Trial of His pacing versus Biventricular pacing in Symptomatic Heart Failure Patients with left bundle branch block (His-Alternative) https://www.jacc.org/doi/10.1016/j.jacep.2021.04.003 - His Corrective Pacing or Biventricular Pacing for Cardiac Resynchronization in Heart Failure https://www.jacc.org/doi/full/10.1016/j.jacc.2019.04.026 FDA FDA Moves to Ban Menthol in Tobacco Products https://www.medscape.com/viewarticle/950223 Features: Losing Both Parents During COVID: A Physician's 'Unwitnessed Grief' https://www.medscape.com/viewarticle/949490 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Cardiac status post COVID-19 in athletes, AF ablation, and bias against procedural doctors are the topics covered by John Mandrola, MD, in this week’s podcast https://www.medscape.com/twic COVID-19 COVID-19 Outbreak Associated with a SARS-CoV-2 R.1 Lineage Variant in a Skilled Nursing Facility After Vaccination Program — Kentucky, March 2021 https://www.cdc.gov/mmwr/volumes/70/wr/mm7017e2.htm Professor Zeynep Tufekci Newsletter: https://www.theinsight.org/p/facts-are-pieces-of-a-puzzle-not Post-COVID-19 Cardiac Involvement in NCAA athletes SARS-CoV-2 Cardiac Involvement in Young Competitive Athletes https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.054824 AF and Durable PV isolation Paroxysmal AF Can Recur but Burden Plunges After 'Durable' Ablation https://www.medscape.com/viewarticle/949566 Radiofrequency vs. Cryoballoon Catheter Ablation for Paroxysmal Atrial Fibrillation: Durability of Pulmonary Vein Isolation and Effect on AF Burden: The RACE-AF Randomized Controlled Trial https://www.ahajournals.org/doi/10.1161/CIRCEP.120.009573 Bias Against Procedures: Apr 9, 2021 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/949000 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

COVID-19 vaccine-related clotting, vitamin D, anticoagulation strategies before PCI, and a good intervention at end of life are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-19: How Some COVID-19 Vaccines Could Cause Rare Blood Clots https://www.medscape.com/viewarticle/949262 FAQ: What to Know About the J&J Vaccine Pause https://www.medscape.com/viewarticle/949231 Vitamin D Screening: Don't Screen for Vitamin D in General Population, Says US Task Force https://www.medscape.com/viewarticle/949167 Pre-PCI AC Decisions: Parity Whether Anticoagulation Is Halted or Not for Unplanned Cath https://www.medscape.com/viewarticle/949064 Uninterrupted Oral Anticoagulant Therapy in Patients Undergoing Unplanned Percutaneous Coronary Intervention https://doi.org/10.1016/j.jcin.2021.01.022 Pacemaker or Defibrillator Surgery without Interruption of Anticoagulation https://www.nejm.org/doi/full/10.1056/nejmoa1302946 Continued vs. interrupted direct oral anticoagulants at the time of device surgery, in patients with moderate to high risk of arterial thrombo-embolic events (BRUISE CONTROL-2) https://doi.org/10.1093/eurheartj/ehy413 A Superb Intervention at End of Life: Use of Comfort Care Increasing After Stroke, May Reduce Costs https://www.medscape.com/viewarticle/949297 Decade‐Long Nationwide Trends and Disparities in Use of Comfort Care Interventions for Patients With Ischemic Stroke https://doi.org/10.1161/JAHA.120.019785 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

COVID-19, COVID-19 vaccines, hybrid AF ablation TAVR and who gets to be called a doctor are the topics by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic COVID-19 UK Regulators to Offer Under-30s Alternative to AZ COVID Vaccine https://www.medscape.com/viewarticle/948934 - News - Communicating the potential benefits and harms of the Astra-Zeneca COVID-19 vaccine https://wintoncentre.maths.cam.ac.uk/news/communicating-potential-benefits-and-harms-astra-zeneca-covid-19-vaccine/ Hybrid Ablation for Persistent AF - Hybrid Convergent Procedure for the Treatment of Persistent and Long-Standing Persistent Atrial Fibrillation https://www.ahajournals.org/doi/10.1161/CIRCEP.120.009288 - Converge trial Rationale Paper https://doi.org/10.1016/j.ahj.2020.02.016 - Approaches to Catheter Ablation for Persistent Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/NEJMoa1408288 - Toward evidence-based medical statistics. 2: The Bayes factor https://pubmed.ncbi.nlm.nih.gov/10383350/ TAVR - TAVR Feasible, Comparable to Surgery in Rheumatic Heart Disease https://www.medscape.com/viewarticle/948832 - Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Rheumatic Aortic Stenosis https://doi.org/10.1016/j.jacc.2021.02.032 - Upsides, Downsides for TAVR, Minimally Invasive AVR https://www.medscape.com/viewarticle/946104 - Minimally invasive surgery versus transcatheter aortic valve replacement: a systematic review and meta-analysis https://openheart.bmj.com/content/8/1/e001535#ref-9 Who Should Get to Be Called 'Doctor'? https://www.medscape.com/viewarticle/948887 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

COVID-19, long-COVID, the language of medicine, childhood obesity, and open notes are the topics covered by John Mandrola, MD, in this week's podcast. https://www.medscape.com/twic COVID-19 AstraZeneca COVID Vaccine: Clotting Disorder Mechanism Revealed? https://www.medscape.com/viewarticle/948560 Long COVID Long COVID Brings Welcome Attention to POTS https://www.medscape.com/viewarticle/948174 Keep Both 'Renal' and 'Nephro' in Glossary of Kidney Disease https://www.medscape.com/viewarticle/948451 'Striking' Increase in Childhood Obesity During Pandemic https://www.medscape.com/viewarticle/948350 COVID-19 and Changes in Child Obesity. https://pediatrics.aappublications.org/content/early/2021/03/01/peds.2021-050123 Starting Monday, Patients Can Read Your Notes: 5 Key Things https://www.medscape.com/viewarticle/948508 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

COVID-19, AF detection post stroke, new measures of heart function, and structural racism in quality measures are the topics covered by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic COVID-19 NIH Rebukes AstraZeneca Vaccine Interim Data: 'Incomplete' https://www.medscape.com/viewarticle/947954 Neutralizing Antibodies Against SARS-CoV-2 Variants After Infection and Vaccination https://jamanetwork.com/journals/jama/fullarticle/2777898 AF and Stroke Insertable Cardiac Monitors Improve AF Detection After Stroke https://www.medscape.com/viewarticle/947986 Perfection in LV Function Measurement Adding Strain Measure to LVEF Better Predicts Later HF https://www.medscape.com/viewarticle/948114 Association of Left Ventricular Systolic Function With Incident Heart Failure in Late Life https://jamanetwork.com/journals/jamacardiology/fullarticle/2777414 Is the Left Ventricular Ejection Fraction Measurement Still Preeminent?—New Measures to Quantify Subclinical Systolic Dysfunction https://jamanetwork.com/journals/jamacardiology/fullarticle/2777412 Structural Racism in Pay for Performance Association Between the Proportion of Black Patients Cared for at Hospitals and Financial Penalties Under Value-Based Payment Programs https://jamanetwork.com/journals/jama/fullarticle/2777701 Twitter Thread from Rishi Wadhera https://twitter.com/rkwadhera/status/1374380385560186883 References: Sowell, Thomas A Conflict of Visions https://en.wikipedia.org/wiki/A_Conflict_of_Visions You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

COVID-19, Fish Oil and AF risk, SGLT2 inhibitors and renal outcomes, and TAVR vs SAVR are the topics discussed by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic COVID-19 EMA Launches Review of Clot Risk With AstraZeneca COVID Vaccine https://www.medscape.com/viewarticle/947393 AZ Vaccine Safe Overall but Questions Remain over Unusual Clots https://www.medscape.com/viewarticle/947733 Fish Oil and AF Dose-Related AF Risk With Omega-3 Fatty Acids? https://www.medscape.com/viewarticle/947542 Effect of Marine Omega-3 Fatty Acid and Vitamin D Supplementation on Incident Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2777469 Omega-3 Fatty Acids and Atrial Fibrillation https://jamanetwork.com/journals/jama/fullarticle/2777450 SGLT2i and Renal Outcomes Ertugliflozin: Renal Benefits in Additional VERTIS CV Analyses https://www.medscape.com/viewarticle/947668 Cardiovascular Outcomes with Ertugliflozin in Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2004967 Effects of ertugliflozin on kidney composite outcomes, renal function and albuminuria in patients with type 2 diabetes mellitus: an analysis from the randomised VERTIS CV trial https://link.springer.com/article/10.1007/s00125-021-05407-5 TAVR vs SAVR TAVR vs SAVR in Low-Risk Patients: What We Do and Don't Know https://www.medscape.com/viewarticle/946173 Mortality in trials on transcatheter aortic valve implantation versus surgical aortic valve replacement: a pooled meta-analysis of Kaplan-Meier-derived individual patient data https://pubmed.ncbi.nlm.nih.gov/32236543/ Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk https://www.jacc.org/doi/full/10.1016/j.jacc.2020.12.052 Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement https://www.nejm.org/doi/full/10.1056/NEJMoa1910555 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

COVID-19, heart failure classifications, DOAC after bioprosthetic valves, and Medicare spending in the pandemic year Are the topics discussed by John Mandrola, MD, in this week’s podcast. https://www.medscape.com/twic I. COVID-19 Vaccination in Israel COVID-19 Vaccination Linked to Less Mechanical Ventilation https://www.medscape.com/viewarticle/946568 BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting https://www.nejm.org/doi/full/10.1056/NEJMoa2101765 II. Heart Failure Classification Heart Failure Redefined With New Classifications, Staging https://www.medscape.com/viewarticle/947048 Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure https://doi.org/10.1016/j.cardfail.2021.01.022 Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa1908655 Sacubitril/Valsartan Across the Spectrum of Ejection Fraction in Heart Failure https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.044586 III. DOACs In Bioprosthetic Valves -- DOACs Offered After Heart Valve Surgery Despite Absence of Data https://www.medscape.com/viewarticle/947193 Off-label Use of Direct Oral Anticoagulants in Patients Receiving Surgical Mechanical and Bioprosthetic Heart Valves https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2777141 Dabigatran versus Warfarin in Patients with Mechanical Heart Valves https://www.nejm.org/doi/full/10.1056/nejmoa1300615 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000665 Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document.... https://academic.oup.com/europace/article/19/11/1757/4098134 IV. Pandemic Slices Medicare Physician Spending in First Half of 2020: AMA https://www.medscape.com/viewarticle/946984 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Cardiac studies in professional athletes after COVID-19 infection, percutaneous valve repair, AF screening, and social media are the topics discussed by John Mandrola, MD, in this week’s podcast. To read a partial transcript or to comment https://www.medscape.com/twic COVID and the Athletic Heart Incidence of Cardiac Pathology Post-COVID in Pro Athletes < 1% https://www.medscape.com/viewarticle/946902 Prevalence of Inflammatory Heart Disease Among Professional Athletes With Prior COVID-19 Infection Who Received Systematic Return-to-Play Cardiac Screening https://jamanetwork.com/journals/jamacardiology/fullarticle/2777308 Percutaneous Valve Repair Delirium Common, Costly After Mitral, Tricuspid Valve Repair https://www.medscape.com/viewarticle/946736 Prevalence and Impact of Post-Procedural Delirium After Percutaneous Repair of Mitral and Tricuspid Valves https://www.jacc.org/doi/full/10.1016/j.jcin.2020.11.031 AF Screening AF Screening in Asymptomatic Older Individuals Shows Promise https://www.medscape.com/viewarticle/946844 Screening for Atrial Fibrillation in the Older Population A Randomized Clinical Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2776728 Social Media JAMA Podcast on Racism in Medicine Faces Backlash https://www.webmd.com/sex-relationships/news/20210304/jama-podcast-on-racism-in-medicine-faces-backlash Time's Up Founder Choo Accused in Harassment Mishandling https://www.medscape.com/viewarticle/946678 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Risk factors for COVID-19, CMR after COVID-19, and two important obesity studies are discussed in this week’s podcast. To read a partial transcript or to comment https://www.medscape.com/twic Cardiometabolic Conditions and COVID19 Most Severe COVID Tied to Four Cardiometabolic Conditions https://www.medscape.com/viewarticle/946488 Coronavirus Disease 2019 Hospitalizations Attributable to Cardiometabolic Conditions in the United States: A Comparative Risk Assessment Analysis https://www.ahajournals.org/doi/10.1161/JAHA.120.019259 CMR after COVID19 Myocardial Injury Seen on MRI in 54% of Recovered COVID https://www.medscape.com/viewarticle/946287 Patterns of myocardial injury in recovered troponin-positive COVID-19 patients assessed by cardiovascular magnetic resonance https://doi.org/10.1093/eurheartj/ehab075 Obesity Trials Semaglutide for Weight Loss? A Good First STEP, With Caveats https://www.medscape.com/viewarticle/945630 Once-Weekly Semaglutide in Adults with Overweight or Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2032183 Major Breakthrough in Weight Loss With Semaglutide? https://www.medscape.com/viewarticle/940841 Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity https://jamanetwork.com/journals/jama/fullarticle/2777025 Features Fired for Good Judgment a Sign of Physicians' Lost Respect https://www.medscape.com/viewarticle/946286 A Tribute to Bernard Lown https://www.medscape.com/viewarticle/946447 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net